Dr Alphonsus St Rose is a consultant physician (internal medicine), internist and gastroenterologist. He is a member of the American College of Gastroenterology and can be reached at: stroserae@gmail.com
By Dr Alphonsus St Rose
Healthcare has been in an unconscionable and shameful crisis for some time now. A humanitarian disaster and injustice to the hard-working people of this land of ours, who cannot all access and afford a decent modicum of healthcare delivery service. For a country that has for years, consistently experienced diminishing economic returns to now being “BROKE” means that equal opportunity access (which is the policy framework aimed at closing the poverty, inequality and inequity gaps) to proper healthcare, education, economic inclusion, prosperity and social justice, will now be more inaccessible than ever before.
The expectations of our democracy, rooted in one person, one vote, embracing the principles of equality, transparency, integrity, good faith, fairness and due process, are all being stressed and tested more so now by COVID-19.
Healthcare is the most important and critical issue the electorate must confront going into this election. COVID-19 has now compounded the healthcare crisis as the greatest existential threat facing you the electorate, the economy and our democracy.
It has exposed the contradictions rooted in a lack of equal opportunity to access healthcare services, an essential right of every citizen of this country, but that which successive governments until now are yet to secure for the citizens. That is the inconvenient truth, context and perspective, however upsetting, that defines our ongoing healthcare crisis in these critical and difficult times.
The disease burden of which we know absolutely nothing is concerning, because we are poorly lacking in terms of a credible, compassionate and comprehensive, evidence-based and driven, National COVID-19 Strategy, of which public health policy directives, testing and protocol compliance are key. This present trajectory in the number of cases detected is an important and worrisome shift, trending in the wrong direction, more so now, with COVID-19 deaths, as we grapple with saving lives and jump-starting a battered economy.
To bring the COVID-19 spread under control will require implementing the necessary public health measures to curb this second and any other wave(s) of a COVID-19 exponential growth. This calls for honest leadership, acting with a clear sense of purpose and defined end-points. The approach has to be inclusive and collective, on a united national platform, to implement a decisive national emergency COVID-19 strategic plan.
This hopefully can buy us some time to mitigate any overheating of our already overburdened healthcare delivery system and the economy. However, the pedalling of a deceptive and hypocritical conspiracy “back door vs front door” theory, while vulgarizing the data for political or economic expediency is unacceptable and has to stop.
Until the virus is contained by a combination of public health policies, protocols, community-wide education campaigns, in addition to the wide availability and safe use of a vaccine and other therapeutic agents, we are all in for a rough and daunting next couple years of political, social and economic hardships. Importantly, the negative psychological impact of this pandemic on the populace must not be underestimated.
This demands from all of us stricter adherence to all the protocols, acting in good faith and good conscience to do all the right things, because this really is about us dealing with a virus that is highly contagious, transmissible and deadly.
Our measure of COVID-19 success will be benchmarked as a referendum on this administration’s “leadership”, and its ability to govern. This is hinged on trust, transparency, honesty, confidence and integrity in the public health policy directives and the information disseminated publicly in relation to this pandemic. This is a battle for survival no more than it is a battle of common decency towards humanity, where conviction, purpose and cause must supersede ambition and greed.
The medical fraternity and front-line workers are all dedicated to caring for the sick, never mind that conditions today are very different. While we have to do our duty to society, most of us are worried about having to execute our duties with a very different clinical and psychological mind-set. Saving a patient’s life in this context must also focus on our own safety too; as medical personnel getting infected would lead to a disastrous outcome. So please, let us all protect each other by strictly complying with the protocols.
To prevent a total shut-down, seems unavoidable, given the present circumstances as both our front (principal) and back doors are porous. In the interim, we must begin enforcing the containment and mitigation measures by reinstating the curfew and mandatory wearing of masks in public, in addition to social distancing, hand sanitizing and crowd/ avoidance management. Once the disease prevalence surpasses a critical predetermined threshold, then the public health “circuit breakers” should automatically chip-in and the country shut-down for at least one month.
Our citizens are required to be more responsible now by following the public health protocols. Be patriotic and unselfish. Protect each other. With our freedoms and liberties come individual and collective responsibilities.
Any administration would have had serious challenges dealing with this COVID-19 pandemic. These challenges have been made exponentially worse by the reckless culture of fiscal indiscipline by this current administration; its fiscal priorities are messed up, hence our illiquid as well as insolvent status – a very uncomfortable position for any administration attempting to navigate an essentially contracted monetary and fiscal space.
Whether the country is broke or the COVID-19 fund has dried up, the government’s responsibility first and foremost, is not to secure the economy, but rather to find the money to fund the COVID-19 emergency containment/mitigation plan, provide a social relief/safety net to protect the elderly, unemployed and vulnerable people in our society. We must save lives to give life to the economy which obviously has to play second fiddle.
Any other construct will be a painful drawn-out exercise for the majority of us in this country. Political and economic expediency must never supersede the right to survival, happiness and shared prosperity of the citizenry. In difficult times like this COVID-19 pandemic, the citizens must and will make their fair share of sacrifices (like they have done continuously for 41 years since independence) but so too must the government and the wealthy. For this is the shared and collective responsibility this crisis demands of all of us. That must be the reset.
For 41 years since independence, the citizens have been sold a false narrative of increased stimulus and incentive packages (much of which has served principally the private sector and the upper 10 percent) fueled by an obviously failed trickle-down economics principle. Why?
Any market deregulation, economic stimulus packages and tax incentive bills must address the circumstances to benefit those who need it most. For if it goes to those who least need it, then the resultant inequality and inequity would serve only to concentrate political and economic power in the hands of a very few who now will assume a monopoly on growth, progress and development. That in no way can be described as ground-breaking intervention aimed at rescuing an ailing society and economy.
The fact that we cannot adequately meet our citizens’ healthcare and educational needs is a crisis; the fact that 50 percent or more of our youth are unemployed is a crisis; the fact that our middle class is rapidly shrinking and the poverty pool is widening is a crisis; the fact that median household income continues to drop is a crisis; the fact that working-class wages remain stagnant while the wage gap widens (because of high inflation as well as unrestricted profiteering by the upper 10 percent) is a crisis. The fact that corruption is now systemic and institutionalized while lawlessness is becoming the norm, is a crisis.
Our destruction of the planet and the man-made ravages of climate change prohibiting us from enjoying the benefits of mother earth is perhaps our biggest present-day global crisis alongside poverty and inequality.
If these are the endpoints, outcomes or adverse reactions of the medicine we have been prescribed for 41 years since Independence, then yes, the medicine is worse than the disease.
This administration now has its fingerprints on taking us down the cliff of financial misery and the moral perils of insolvency while telling us that we do not possess cushioning capacity to compensate. Why then do we have a Central Bank? Do we possess monetary sovereignty? If so, why should we ever go “Broke”? Something seems amiss with our financial and economic narrative and reality.
Contrary to traditional economic thinking perhaps this is the time to actually broaden the deficit, for what choice do we have? We’re broke anyway. While fiscal discipline and austerity measures are coming, any attempt(s) now to “balancing the budget/deficit” will mean reduced fiscal spending for the necessary social, economic, educational, healthcare and infrastructural projects for those who need it most. This, in my humble opinion, is the wrong and indeed a bad prescription. Why punish the needy while allowing the wealthy open-ended opportunities?
That the country is broke is no reason to demand more sacrifice from hard-working people beyond that which they have already made. Go find the money prime minister Allen Chastanet and invest in the right things for all the right reasons and we might just be okay. Yes, it will broaden the fiscal deficit, but might we just use the opportunities the deficit present to reset and reinvest appropriately for greater, healthier and a more equitable prosperity?
The answer may well be hidden in the lower 90 percent. This is what bold and necessary change (course correction) is all about. This is what moral courage is all about. This is what conviction, compassion and empathy is all about.
The truth matters. The people matter. This is the people’s time. 
About the Author
A long but well written piece with poignant points that reiterate the need to make the hard decisions of redirecting funds towards managing Covid19 and closing our borders for 4 weeks ( President Elect, Joe Biden’s Head of his Covid Task Force is of the view that lockdown for 4 to 6 weeks will help manage the accelerated rate of covid cases and deaths, presently experienced in the USA).
The question now is what is of greater importance of our legislators in St Lucia.